Abstract
Background: Non-suppressive or partially suppressive L-T4 treatment demonstrated to be effective in reducing the volume of the nodules. However, studies with long follow-up are lacking and significant controversy exists regarding the efficacy of non-suppressive L-T4 treatment in benign nodular goiter. Aim: The goal of this study was to determine the evolution of thyroid nodules in subjects treated with a non-suppressive levothyroxine (L-T4) dose, compared to untreated subjects. Design and patients: We followed for a period of 1-9 years the thyroid nodule size in 356 female patients in the age range 19-45 at study entry, of which 201 untreated (Group 0) and 165 treated with a non-suppressive L-T4 dose (Group L-T4). Measurements: We determined the volume of thyroid nodules by ultrasonography. Results: The initial mean nodule volume in Group 0 and Group L-T4 was 3.91 ± 6.87 and 4.01 ± 7.35 mL, respectively. Nodule volume increase was inversely correlated to the initial volume. The final volume was slightly higher in untreated than in L-T4 treated subjects (5.37 ± 8.49 and 4.39 ± 6.72 mL). In both groups, the mean of annual fold increase of nodule volume was inversely correlated with the follow-up duration (P <0.0046), indicating a slower growth as time advances. In the subjects treated with L-T4, the mean annual increase of nodule volume was significantly minor compared to untreated subjects. Concomitant nodules in ten multinodular goiters exhibited totally independent evolution, demonstrating that intranodular factors are more important for the nodule behavior than extra nodular factors. Conclusions: Our study demonstrates that the growth of benign thyroid nodules is inversely correlated to their size, benign nodules naturally growth slowly as time advances, and that a chronic treatment with L-T4 at a non-TSH-suppressive dose significantly reduces their growth.
| Original language | English |
|---|---|
| Pages (from-to) | 1181-1186 |
| Number of pages | 6 |
| Journal | Journal of Endocrinological Investigation |
| Volume | 37 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - Dec 7 2014 |
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Keywords
- Benign nodular goiter
- Keyterms: Thyroid
- Levothyroxine
- Ultrasonography
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism
- Endocrinology
Cite this
Evolution of benign thyroid nodules under levothyroxine non-suppressive therapy. / Puzziello, Alessandro; Carrano, Mario; Angrisani, Elisabetta; Marotta, Vincenzo; Faggiano, Antongiulio; Zeppa, Pio; Vitale, Mario.
In: Journal of Endocrinological Investigation, Vol. 37, No. 12, 07.12.2014, p. 1181-1186.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Evolution of benign thyroid nodules under levothyroxine non-suppressive therapy
AU - Puzziello, Alessandro
AU - Carrano, Mario
AU - Angrisani, Elisabetta
AU - Marotta, Vincenzo
AU - Faggiano, Antongiulio
AU - Zeppa, Pio
AU - Vitale, Mario
PY - 2014/12/7
Y1 - 2014/12/7
N2 - Background: Non-suppressive or partially suppressive L-T4 treatment demonstrated to be effective in reducing the volume of the nodules. However, studies with long follow-up are lacking and significant controversy exists regarding the efficacy of non-suppressive L-T4 treatment in benign nodular goiter. Aim: The goal of this study was to determine the evolution of thyroid nodules in subjects treated with a non-suppressive levothyroxine (L-T4) dose, compared to untreated subjects. Design and patients: We followed for a period of 1-9 years the thyroid nodule size in 356 female patients in the age range 19-45 at study entry, of which 201 untreated (Group 0) and 165 treated with a non-suppressive L-T4 dose (Group L-T4). Measurements: We determined the volume of thyroid nodules by ultrasonography. Results: The initial mean nodule volume in Group 0 and Group L-T4 was 3.91 ± 6.87 and 4.01 ± 7.35 mL, respectively. Nodule volume increase was inversely correlated to the initial volume. The final volume was slightly higher in untreated than in L-T4 treated subjects (5.37 ± 8.49 and 4.39 ± 6.72 mL). In both groups, the mean of annual fold increase of nodule volume was inversely correlated with the follow-up duration (P <0.0046), indicating a slower growth as time advances. In the subjects treated with L-T4, the mean annual increase of nodule volume was significantly minor compared to untreated subjects. Concomitant nodules in ten multinodular goiters exhibited totally independent evolution, demonstrating that intranodular factors are more important for the nodule behavior than extra nodular factors. Conclusions: Our study demonstrates that the growth of benign thyroid nodules is inversely correlated to their size, benign nodules naturally growth slowly as time advances, and that a chronic treatment with L-T4 at a non-TSH-suppressive dose significantly reduces their growth.
AB - Background: Non-suppressive or partially suppressive L-T4 treatment demonstrated to be effective in reducing the volume of the nodules. However, studies with long follow-up are lacking and significant controversy exists regarding the efficacy of non-suppressive L-T4 treatment in benign nodular goiter. Aim: The goal of this study was to determine the evolution of thyroid nodules in subjects treated with a non-suppressive levothyroxine (L-T4) dose, compared to untreated subjects. Design and patients: We followed for a period of 1-9 years the thyroid nodule size in 356 female patients in the age range 19-45 at study entry, of which 201 untreated (Group 0) and 165 treated with a non-suppressive L-T4 dose (Group L-T4). Measurements: We determined the volume of thyroid nodules by ultrasonography. Results: The initial mean nodule volume in Group 0 and Group L-T4 was 3.91 ± 6.87 and 4.01 ± 7.35 mL, respectively. Nodule volume increase was inversely correlated to the initial volume. The final volume was slightly higher in untreated than in L-T4 treated subjects (5.37 ± 8.49 and 4.39 ± 6.72 mL). In both groups, the mean of annual fold increase of nodule volume was inversely correlated with the follow-up duration (P <0.0046), indicating a slower growth as time advances. In the subjects treated with L-T4, the mean annual increase of nodule volume was significantly minor compared to untreated subjects. Concomitant nodules in ten multinodular goiters exhibited totally independent evolution, demonstrating that intranodular factors are more important for the nodule behavior than extra nodular factors. Conclusions: Our study demonstrates that the growth of benign thyroid nodules is inversely correlated to their size, benign nodules naturally growth slowly as time advances, and that a chronic treatment with L-T4 at a non-TSH-suppressive dose significantly reduces their growth.
KW - Benign nodular goiter
KW - Keyterms: Thyroid
KW - Levothyroxine
KW - Ultrasonography
UR - http://www.scopus.com/inward/record.url?scp=84940946953&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84940946953&partnerID=8YFLogxK
U2 - 10.1007/s40618-014-0128-z
DO - 10.1007/s40618-014-0128-z
M3 - Article
C2 - 25008459
AN - SCOPUS:84940946953
VL - 37
SP - 1181
EP - 1186
JO - Journal of Endocrinological Investigation
JF - Journal of Endocrinological Investigation
SN - 0391-4097
IS - 12
ER -